Testosterone deficiency – defined as low levels of total testosterone in the presence of symptoms - is common among men with obesity and type 2 diabetes, with a reported prevalence of 58% and 45%, respectively. However, even after adjusting for age and BMI (a surrogate measure for obesity), the prevalence of subnormal free testosterone levels in men with type 2 diabetes is higher than in men without.

Insulin resistance occurs when the body’s cells become insensitive to the insulin, which is a hormone that is necessary for transport of blood sugar (glucose) into cells. To compensate for the resistance to insulin, the pancreas increases insulin production up to the point until the pancreas’ capability to produce insulin is exhausted.

Here we summarize the results of a study conducted by a research team at the Division of Endocrinology, Diabetes and Metabolism, State University of New York. This study specifically selected men with type 2 diabetes based on low free testosterone levels. The aims of the study were to investigate:

1) The impact of testosterone deficiency on insulin resistance, inflammation, and body composition in men with type 2 diabetes.

In 2010, the Endocrine Society published a Clinical Practice Guideline “Testosterone Therapy in Adult Men With Androgen Deficiency Syndromes”, which addressed important issues regarding the diagnosis and treatment of male hypogonadism.

Since publication of this Guideline, several high-quality trials have been conducted, warranting an update of the 2010 recommendations in several areas, especially that of testosterone therapy in men with the metabolic syndrome, type 2 diabetes, sexual dysfunction, and frailty. In addition, many of the previously stated contraindications to testosterone therapy – including severe lower urinary tract symptoms (LUTS) and untreated obstructive sleep apnea (OSA) - have been reexamined in recent trials.

Here we summarize the results of a systematic analysis of the latest high-quality studies, which call for some important updates of the 2010 Endocrine Society Clinical Practice Guidelines for Male Hypogonadism.

14 September 2010

Aging is associated with a reduction in testosterone levels in the blood. This reduction causes a number of symptoms, one of which is losing muscle mass.

This small, well-designed 12-month study looked at the effect of the testosterone patch on body composition and hormones in 60 men aged ≥55 years who were healthy and not obese, and who had low-to-normal testosterone levels and typical testosterone deficiency symptoms.